Impact of implementing the neonatal early-onset sepsis calculator in two units in Colombia

Background: Early-onset neonatal sepsis poses a significant challenge due to its impact on neonatal health outcomes. Empirical antibiotic treatment often leads to unnecessary antibiotic use and hospitalizations, as well as excessive ordering of laboratory tests. The early-onset sepsis calculator (EOSCalc) aims to mitigate these issues by optimizing antibiotic use and resource allocation. This study aims to evaluate the impact of implementing the EOSCalc in newborns ≥ 34 weeks in two NICUs in Manizales, Colombia. Methods: A quasi-experimental, before–after design was employed in two NICUs in Manizales, Colombia, involving 258 newborns ≥ 34 weeks of gestational age. Statistical analyses were conducted to compare pre- and post-implementation periods. Results: Following EOSCalc implementation, there was a significant reduction in antibiotic prescriptions (28% to 12.4%; p = 0.001) and total antibiotic dosage (p < 0.001). Antibiotic use rates and prescription rates per 1000 patient-days decreased from 15.38 to 7.88 and from 4.62 to 2.05, respectively. Although not statistically significant, a decrease in hospitalizations for suspected early-onset neonatal sepsis was observed. Furthermore, significant reductions were noted in evaluations for blood cultures (30.2% to 17.1%; p = 0.013), C-reactive protein (72% to 8.5%; p < 0.001), and complete blood counts (72.9% to 14.7%; p < 0.001), with no impact on hospital length of stay. There were no cases of neonatal sepsis readmissions post-EOSCalc implementation. Conclusions: The implementation of EOSCalc effectively optimized antibiotic use and diagnostic resource allocation for suspected neonatal sepsis without compromising clinical outcomes.